A stoma is a surgically created connection between the inside of the body and the skin. Stomas take a lot of getting used to at first, but for many sufferers they lead to lasting freedom from symptoms and sometimes to an improvement in quality of life.
What is a stoma?
A stoma is an artificially created body opening to the outside that connects an organ – whether trachea (tracheostoma), urinary bladder (urostoma), stomach (gastrostoma) or intestine (ileostoma, colostoma) – with the body surface. There are various reasons for the surgical creation of a stoma – all of them have in common that without a stoma the health condition of the affected person would often deteriorate dramatically.
What do you need to be aware of as a stoma wearer?
Many affected persons spontaneously react defensively when they are confronted with the therapy option “stoma placement” for the first time, because a tracheostoma inevitably attracts attention with its exposed position, a uro- or colostoma is automatically associated with the danger of “leaking” and “smelling”.
In most cases, the creation of a permanent stoma is also associated with a serious underlying disease – be it cancer or a chronic intestinal disease – which has sometimes already led to a reduction in quality of life over many years. For example, the chronic bowel diseases Crohn’s disease and ulcerative colitis lead to recurrent bleeding, bowel obstruction, massive colic and an increased risk of cancer. Often, stoma placement leads to an improvement in quality of life for patients with bowel inflammation; for cancer patients, the stoma is an additional problem on top of the cancer diagnosis.
Many questions concerning the handling of the stoma can be clarified in advance. Every hospital works with trained stoma therapists who, together with the patient, can select the best possible stoma care and allay many concerns. Of course, wearing a stoma often requires a change in thinking: some sports or even occupations are only possible to a limited extent with a stoma, and the partner must also come to terms with the new situation.
Restrictions due to stomas
With a tracheostoma, smelling and tasting will only be possible to a very limited extent, as the air breathed no longer passes the olfactory cells. Speaking is usually only possible with a speaking tube, because the speech process requires some air to flow through the larynx and cause the vocal cords to vibrate.
In the case of uro- and colostoma, the most important factor is the individually suitable pouching system. There are one-piece and two-piece systems: In the two-piece system, a tightly adhering plastic ring is glued around the stoma and the transparent, white or natural-colored stoma bag is attached to it, with a filter insert to ensure that no unpleasant odor can escape.
In one-piece system, the adhesive ring and the bag are combined. The two-piece system has the advantage that the adhesive ring can remain on the skin for 24 to 48 hours.
Complications with stomas
The tracheostoma bypasses the upper airway, where breathing air is normally cleansed and moistened – making the bronchi susceptible to infection. With all stomas, the hollow organ located inside the body can retract (retraction), which can lead to a reduction in the size of the stoma opening (stenosis) and sometimes requires surgical repair.
If there is inflammation of the stoma environment or an allergic reaction to components of the adhesive ring, the stoma therapist will help. Leaky or “smelly” pouching systems are mostly due to incorrect operation – several surveys of the German ILCO e.V. have shown that these problems are rather seldom reported by those affected.
More serious problems are the psychological burden of a uro- and colostoma with the fear of loud bowel noises and the disturbance of sexual function associated with the stoma, which are mentioned by almost half of those affected. Sometimes sharing in a support group can be helpful.
